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dysfunction, discomfort, and disability arising from oral conditions. Each of the several domains assesses various types of problems experienced. These instruments are included in Appendix D. Consistent with previous investigations (Slade et al., 2005), three OHRQoL estimates were derived from subjects’ responses: severity (cumulative OHIP-14 score), prevalence (proportion of items reported fairly/very often), and extent (number of items reported fairly/very often) of impacts were calculated as measures of OHRQoL. For children ages 6 to 17, we used the Parents Perceptions Questionnaire, which was completed by 286 caregivers of children (Locker et al., 2002). Similar analytical approaches were used to determine Parental Perceptions Questionnaire (PPQ) estimates: severity (cumulative PPQ score), prevalence (proportion of items reported fairly/very often), and extent (number of items reported often/every day) of impacts were calculated as measures of OHRQoL. We planned to use the Early Child Oral Health Impact Scale (ECOHIS) quality-of-life measure for children under 6 years old (Pahel, Rozier, & Slade, 2007), but there were only three participants in this age group; because of limited numbers, these data are not reported. At four of the five sites, surveys were administered just prior to the oral health survey, typically in the waiting area of the clinic, and project staff were available to answer questions or clarify issues that arose. At one site, the questionnaires were distributed with consent forms by the school system to students. 3.3

Oral Health Surveys

Oral health surveys were conducted at each of the five sites. The survey methods were adapted from the World Health Organization (WHO, 1997). As noted earlier, the purpose of performing these oral health surveys was to provide an explicit, quantitative measure of the community context in which the therapists and other dental providers were operating and to provide a robust baseline assessment for future longitudinal studies. A basic dentition status examination and a community periodontal index (CPI) examination, an estimate of periodontal status, were performed. Appendix E presents both the detailed instructions for performing the examinations and the data collection form. The intention was to examine 100 randomly selected individuals at each site: one-third adults (20 years or older), and two-thirds children (6–19 years), with priority given to younger children to facilitate comparisons with available regional and state data. Due to difficulties in scheduling examinations, the final samples were largely convenience samples; primarily because of time constraints associated with scheduling the site visits, we were unable to obtain lists of